The long term objective of this research is to delineate the course and psychosocial etiology of alcohol-related problems in a cohort of male and female future physicians from the periods prior to the initiation of medical school training through the major portion of residency training. The proposed research is to continue a longitudinal study of a medical student cohort currently being surveyed through the third year of medical school. The proposed research will follow this group at 4 additional points: 1) in the final year of medical school, 2) during the internship year, and 3 and 4) during the second and third years of residency training. On a conceptual level, this study addresses theoretical issues reflecting life-span developmental, occupational stress and gender role frameworks for understanding drinking behavior. Some major hypotheses are: 1) The most sizable onset of heavy and problem-related drinking during medical school and residency training will occur in the internship year, 2) The initial male predominance in heavy and problem-drinking will progressively diminish over the course of residency training, and 3) the etiology of problem drinking in future physicians will consist of a combination of pre- training-related "vulnerabilities" brought into the occupational training context (eg. family history of alcoholism or problem drinking, psychological and interpersonal deficits) and stressors derived from the training experience (eg. work overload and sleep deprivation). Respondents will complete self-report questionnaires at each point assessing: alcohol- related problems and consumption patterns, related drug use, symptomatic distress, medical training-related stressors and social support, personal life, and psychosocial assets/deficits (locus of control, self esteem, dependency, masculinity-femininity, social skills and connectedness and drinking motives). Additional variables measured in the current study and the continued focus of analysis in the proposed research include pre- training drinking behaviors and psychosocial experiences. Respondents will also be interviewed with a clinical assessment of address the incidence and prevalence of alcoholism. A variety of multivariate statistical techniques will be utilized to depict the etiologic determinants of alcohol problem onset, remission and chronicity over time in physicians in training. A final goal involves the delineation of strategies aimed at the primary and secondary prevention of alcohol-related impairment in physicians.